Kinematic optimization of deep brain stimulation across multiple motor symptoms in Parkinson's disease.
Kinematic optimization of deep brain stimulation across multiple motor symptoms in Parkinson's disease.
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DOI：
10.1016/j.jneumeth.2011.03.019
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发表时间：
2011-06-15
影响因子：
3
通讯作者：
Giuffrida, Joseph P.
中科院分区：
文献类型：
--
作者：
Mera, Thomas;Vitek, Jerrold L.;Alberts, Jay L.;Giuffrida, Joseph P.
帕金森病（PD）是一种神经退行性疾病，其特征在于包括震颤和运动迟缓（运动缓慢）的运动症状。药物治疗虽然能够在数年内控制这些症状，但随着疾病的进展而变得不那么有效，并导致运动并发症，如药物引起的运动障碍（不自主的异常运动）。脑深部电刺激（DBS）为控制这些患者的运动症状提供了一种替代方法，虽然DBS可有效改善运动症状，但这些改善主要基于电极导线的准确放置以及医务人员在植入后对DBS器械进行充分程控的能力。虽然存在DBS程控指南，但刺激参数和患者结局的选择在很大程度上取决于主观临床评估和执行程控的医务人员的经验。该项目的目的是评估采用定量和客观的方案编制办法的可行性。两名受试者在佩戴小型紧凑型运动传感器时接受了DBS程控的标准程序。当受试者完成运动任务时，从受试者中收集运动学数据，以评价DBS疗效。表征震颤和运动迟缓的定量变量与刺激参数相关。结果表明，不同的刺激设置可能需要不同的运动症状的最佳改善。利用运动分析对DBS参数进行编程的标准化方法可以提供客观的评估方法，编程器可以使用该方法来更好地识别刺激参数，以实现对多种运动症状的最佳改善。
Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor symptoms including tremor and bradykinesia (slowness of movement). Drug treatment, although capable of controlling these symptoms over a number of years, becomes less effective as the disease progresses and leads to motor complications such as drug-induced dyskinesia (involuntary abnormal movements). Deep brain stimulation (DBS) provides an alternative means of controlling motor symptoms in these patients, and while DBS has been effective in improving motor symptoms, these improvements are largely based on accurate placement of the lead and the ability of medical personnel to adequately program the DBS device following implantation. While guidelines exist for DBS programming, selection of stimulation parameters and patient outcome is greatly dependent on subjective clinical assessments and the experience of the medical personnel performing the programming. The aim of this project was to assess the feasibility of using a quantitative and objective approach to programming. Two subjects underwent standard procedures for DBS programming while wearing a small, compact motion sensor. Kinematic data were collected from subjects as they completed motor tasks to evaluate DBS efficacy. Quantitative variables characterizing tremor and bradykinesia were related to stimulation parameters. Results indicated different stimulation settings might be required for optimal improvement of different motor symptoms. A standardized method of programming DBS parameters utilizing motion analysis may provide an objective method of assessment that the programmer can use to better identify stimulation parameters to achieve optimal improvement across multiple motor symptoms.
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影响因子：
158.5
作者：
Obeso, JA;Guridi, J;Wilkinson, S
通讯作者：
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DOI：
10.1073/pnas.96.4.1674
发表时间：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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